Enacting the Behavioral and Social Sciences in the Clinical Setting: Institution-Wide Teaching of Effective Team-Based Care The College of Physicians and Surgeons of Columbia University and the Weill- Cornell Medical Colleges propose to partner in a project to enhance what medical students learn about social sciences and behavioral sciences in their clinical training. The project will accomplish these aims in three broad ways: 1. Increase the amount of teaching offered to students in such topics as doctor- patient relationships, ethics and professionalism, understanding patients'lived experiences, and reflecting on their own practice. The schools plan to adopt innovative narrative methods to help medical students examine their own and their patients'experiences through reading, writing, and hearing the stories of others. These teaching efforts will take place in the hospital where students are themselves providing medical care to individual patients. 2. Increase the teaching skill of physicians and other medical school faculty in an intensive Faculty Scholarship Core. Committed teachers of social, cultural, interpersonal, and ethical dimensions of health care will be invited to work closely with their peers in developing effective teaching methods, creating new teaching approaches, pursuing their own scholarship and research in how medical students learn this material and how best it can be taught. They will be trained in scholarly and research methods so that they have the capacity to disseminate what they learn in academic presentations and publications, thereby improving the teaching of these materials widely. 3. Since the setting of care and the partners of care determine the nature of care, this project will pay great attention to the institutional culture of the teaching hospital in which the students train. Columbia and Cornell share the use of the NewYork-Presbyterian Hospital. The proposers of this project are already collaborating with nurses, social workers, public health professionals, and dentists who work in this hospital to improve team work and patient-centered care. The project would engage medical students in on-going team-based efforts throughout the hospital. Instead of being disillusioned by the indifference and greed of the "real world" of the hospital, this project will expose medical students to the idealism and commitment that most health professionals hold to patients'well-being. A rigorous evaluation plan is proposed, relying on in-depth interviews with faculty and students, careful systematic description of the hospital culture by students in narrative writing and questionnaires, focus group methods to learn what groups of health care professionals think about the care they give. The project anticipates that its work will improve the education of medical students, strengthen the scholarship and pedagogy of faculty, and enable the hospital to deepen its commitment to team- based, respectful, patient-centered care.